| NPI | 1659862134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA R SHRIVER Office Manager 907-344-4243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: AK 741) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-05-21 |